white matter lesion

Hi I am an 32yo white female. I am a Paramedic.I had an MRI because I had 3 episodes of blurriness and flickering in my right visual fields. MRI showed a 1.4cm well defined white matter lesion in my temporal lobe. There was nil enhancement with contrast administration. Ive had no other symptoms but recent fatigue and a dry cough. The neurologist has ordered another MRI in 3 months. He says that its probably nothing but has done a blood test for Angiotensin converting enzyme and LD, both came back normal as well as a general blood test. Im having a chest XRay also to rule out sarcoidosis given the recent fatigue and cough. He says that it is not MS as the lesion is in the wrong spot. The radiology report says that a low grade glioma needs to be considered. My question is what else could it be and what would you say the chances are of it being nothing? (is it common to have these lesions that are of no significance?) What do you think it might be?
Thanks so very much,
Fiona

[FionaS]

Forgot to tell you also that my eyes were tested and had nil abnormalities

[painkiller99]

White matter lesions can occur in many conditions, including MS, hypertension, migraines, exposure to some drugs and toxins, etc.  Your presentation of blurred vision and white matter lesions are not diagnostic of any one particular condition.  Has there been any progression in your condition over the last few months? At this point, it may be advisable to just follow your neurologist's advice and wait for an MRI to be done in 3 months time.

[FionaS]

Firstly thank-you so much for your reply. No there has been no progression of my condition, there has only been 3 episodes of the blurred vision lasting about 20 mins about every 4-6 weeks and they are very similiar and seem to resemble what Ive read about migraines. My neurologist thinks that the white matter lesion is not related at all to these episodes, because of its location. I dont have a history of hypertension. I have been on and off anti-depressants for over a decade and also on minocycline for acne and inhalers for asthma. I will definately have the repeat MRI. Do you think it is possible for the lesion to be of no significance? Or do these generally indicate that something is wrong? Thanks again so much.

[painkiller99]

Any abnormal finding should always be considered. However, the degree of clinical significance cannot be ascertained just based on 1 abnormal finding.  MRI findings, as with most diagnostic procedures, are mostly ancillary/supportive and require correlation with clinical presentation/symptoms.  I would advise you to observe your symptoms and note any progression/worsening, and also wait for the MRI and your neurologist's assessment.

[FionaS]

Thanks again so much.

[FionaS]

I had my repeat MRI after 3 months and it come back indentical (the while matter lesion was unchanged) I still have the same visual episodes every month or two. My neurologist didnt seem concerned about the lesion. The report states that MS would be extremely unlikely due to its location and that a low grade glioma still remains a possibility. Should I have another MRI in the future? If it remains unchanged do I just forget about it in the absense of other symptoms or does it need to be monitored?
Thank-you.